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Individual

MR. KENNETH GENE WETJEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
601 HIGHWAY 6 W, IOWA CITY, IA 52246-2292
(319) 338-0581
Mailing address
18 PHOENIX PL, IOWA CITY, IA 52246-8665
(319) 339-0097

Taxonomy

Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
R 094024-1
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R 094024-1
NURSING LISCENSE
Enumeration date
06/15/2006
Last updated
07/08/2007
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